WILLINGNESS TO PARTICIPATE FORM

DUE DATE:  August 17, 2007

11th Annual Comprehensive Review & Update of Perioperative Echocardiography
February 11-16, 2008 · Sheraton San Diego Hotel & Marina, San Diego, CA

I have received and read the Willingness to Participate letter and the Echo Lecture Schedule. These assignments have been made as a result of an invitation to perform the duties as a faculty member for the above-captioned meeting.

 

  
 I am pleased to participate in all lectures, workshops, case discussions, and/or as moderator as outlined in the Echo Lecture Schedule.
  
 I must decline all.
  
 I must decline the following assignments.
 
   
Name:  
Academic Title:  
Academic Institution:  
Preferred Mailing Address:  
Phone #:  
Fax #:  
E-mail Address:  
Secretary Name:  
Secretary Phone:  

 




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